Provider First Line Business Practice Location Address:
5421 KNIGHT ARNOLD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEMPHIS
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
38115-2816
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
901-691-1604
Provider Business Practice Location Address Fax Number:
901-797-8002
Provider Enumeration Date:
02/01/2011